PMID- 11824949
OWN - NLM
STAT- MEDLINE
DCOM- 20020702
LR  - 20240222
IS  - 0315-162X (Print)
IS  - 0315-162X (Linking)
VI  - 29
IP  - 1
DP  - 2002 Jan
TI  - Minimal clinically important rehabilitation effects in patients with 
      osteoarthritis of the lower extremities.
PG  - 131-8
AB  - OBJECTIVE: To estimate minimal clinically important differences (MCID) of effects 
      measured by the Western Ontario and McMaster Universities Osteoarthritis Index 
      (WOMAC) in patients with osteoarthritis (OA) of the lower extremities undergoing 
      a comprehensive inpatient rehabilitation intervention. METHODS: A prospective 
      cohort study assessed patients' health by the WOMAC at baseline (entry into the 
      clinic) and at the 3 month followup, and by a transition questionnaire asking 
      about the change of "health in general related to the OA joint" during that time 
      period. The WOMAC section score differences between the "equal" group and the 
      "slightly better" and "slightly worse" groups resulted in the MCID for 
      improvement and for worsening. RESULTS: In total 192 patients were followed up. 
      The MCID for improvement ranged from 0.80 to 1.01 points on the continuous WOMAC 
      numerical rating scale from 0 to 10, reflecting changes of 17 to 22% of baseline 
      scores. The MCID for worsening conditions ranged from 0.29 (6%) to 1.03 points 
      (22%). In the transition reply subjectively unchanged patients reported a 
      "pessimistic bias" of 0.35 to 0.51 points, except for the stiffness section. Both 
      MCID and pessimistic bias showed regression to the mean and baseline dependency. 
      CONCLUSION: The assessment of MCID using the transition method is a heuristic and 
      valid strategy to detect particular rehabilitation effects in patients with OA of 
      the lower extremities with the use of the WOMAC, and it is worth implementing. 
      The size of the MCID and of the systematic bias is comparable to that assessed by 
      other methods and in other therapeutic settings.
FAU - Angst, Felix
AU  - Angst F
AD  - Clinic of Rheumatology and Rehabilitation, Zurzach, Switzerland. 
      fangst@datacomm.ch
FAU - Aeschlimann, Andre
AU  - Aeschlimann A
FAU - Michel, Beat A
AU  - Michel BA
FAU - Stucki, Gerold
AU  - Stucki G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Disease Progression
MH  - Female
MH  - *Health Surveys
MH  - Humans
MH  - Leg/*pathology/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis/physiopathology/*psychology/*rehabilitation
MH  - Patient Satisfaction/*statistics & numerical data
MH  - Prospective Studies
MH  - Regression Analysis
MH  - Treatment Outcome
EDAT- 2002/02/05 10:00
MHDA- 2002/07/03 10:01
CRDT- 2002/02/05 10:00
PHST- 2002/02/05 10:00 [pubmed]
PHST- 2002/07/03 10:01 [medline]
PHST- 2002/02/05 10:00 [entrez]
PST - ppublish
SO  - J Rheumatol. 2002 Jan;29(1):131-8.